Factors Associated with Pain Persistence and Disability 12 Months After a New Episode of Nonspecific Low Back Pain in Older Brazilian Adults: A Prospective Cohort Study

Abstract Introduction: Nonspecific low back pain (LBP) is common among older adults and often leads to functional disability and persistent symptoms. Objective:To investigate factors associated with pain persistence and disability 12 months after an acute episode of LBP in Brazilian older adults. Materials and Methods: This prospective cohort study used data from the international Back Complaints in the Elders consortium (BACE-Brazil). The outcomes assessed were the persistence of LBP and disability after 12 months, as well as the associated clinical, sociodemographic, and functional factors. Results: A total of 602 participants (mean age, 67.6 ±7 years) were followed at baseline, and 448 were reassessed after 12 months. Overall, 56% of the participants reported persistent pain, and 40% disability. The factors associated with the persistence of LBP after 12 months included physical inactivity (0.83 [95% CI, 0.64–0.97]), negative beliefs (0.97 [95% CI, 0.96–0.98]), moderate pain (5.64 [95% CI, 4.07–7.81]), severe pain (5.60 [95% CI, 4.05–7.76]), moderate numbness (1.25 [95% CI, 1.09–1.43]), and severe numbness (1.18 [95% CI, 1.03–1.35]). Disability after 12 months was associated with comorbidities (1.20 [95% CI, 1.01–1.42]), negative beliefs (0.98 [95% CI, 0.97–0.99]), daily pain (1.23 [95% CI, 1.07–1.42]), constant pain (1.20 [95% CI, 1.06–1.36]), moderate weakness (1.21 [95% CI, 1.08–1.35]), and recurrent falls (1.23 [95% CI, 1.09–1.39]). Conclusion: The persistence of LBP and disability after 12 months revealed multifactorial factors associated with these outcomes, emphasizing the importance of multidimensional and individualized care strategies.